頭部重度外傷意識昏迷中西結合治療甦醒病例報告

A Loss of Consciousness of Severe Head Injury Wake up Case Treated with Integrated Medicine

黃玨穎(Chueh-Ying Huang) ； 陳貞如(Chen-Ju Chen) ； 鄭棋安(Kei-An Cheng) ； 陳榮洲(Jung-Chou Chen)

《中西整合醫學雜誌》 14卷2期 (2012/06) Pp. 33-46

https://doi.org/10.29613/JICWM.201206.0004

摘要

本病例報告為一位23歲男性服兵役的患者，因騎摩托車意外頭部嚴重受傷，意識昏迷1至2小時後被送往南部某教學醫院急診室，在急診室時，患者四肢自主意識抖動，左耳出血。昏迷指數（GCS）：E3V1M5，SPO2 = 98%，BP = 171/80mmHg。腦部電腦斷層顯示：雙側額、顳、頂葉（frontal-temporal-parietal lobes），急性顱內出血（ICH），蛛網膜下腔出血（SAHs），雙側硬腦膜下腔出血（SDH），腦水腫（Brain swelling），左側輕度氣腦症（Pneumocephalus）。因此緊急施行開顱手術，術後引起癲癇發作，刺棘型發燒，中樞神經性發熱，神識不清，但生命徵象穩定。於開刀第19天，家屬要求會診中醫治療，經服中藥湯劑及針刺後，患者在中西結合治療第三天，意識恢復，於第十七天出院，目前病人回醫院復健，雙腿能自行走路，做手臂運動，及簡單數學運算。

關鍵字

頭部外傷 ； 意識昏迷 ； 開顱手術 ； 中藥湯劑 ； 針刺

並列摘要

This 23 years old male who is in the army fell out from a motorcycle on Oct. 7, 2011 and led to severely traumatic head injury and loss of consciousness. After 1~2 hours he was sent to emergency room. In ER, his four limbs were shaking spontaneously and left ear was bleeding. Glasgow coma scale was E3V1M5, SPO2 = 98%, and blood pressure was 171/80 mmHg. Brain CT showed that bilateral frontal-temporal-parietal lobes present acute ICHs, SAHs and bilateral hemisphere SDH with brain swelling and left mild pneumocephalus. Therefore the patient accepted emergent brain craniotomy. After operation he had epileptic attack, spiking fever, central fever and his vital sign was under control. However his consciousness was still not clear. After 19 days of operation, his family asked for Chinese Medicine intervention. The treatment was included Chinese medicinal decoction and acupuncture. After 3rd day of integrated medicine, the patient conscious was recovered and discharged at 17th day. Now he came back hospital and rehabilitation. He can walk on his own foot all by himself, do arm exercise and even do some simple math.

並列關鍵字

Traumatic head injury ； Loss of consciousness ； Brain craniotomy ； Chinese medicinal decoction and Acupuncture